MEDICARE: NORTHLIGHT THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1023963568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHLIGHT THERAPY

Provider Business Mailing Address
First Line	:	2738 NORTH ST
Second Line	:
City	:	MONTPELIER
State	:	VT
Zip	:	05602-9646
Country	:	US
Telephone Number	:	802-839-6360
Fax Number	:

Provider Business Practice Location Address
First Line	:	2738 NORTH ST
Second Line	:
City	:	MONTPELIER
State	:	VT
Zip	:	05602-9646
Country	:	US
Telephone Number	:	802-839-6360
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CASSIA LEENDERTSE
Credential	:	LICSW
Telephone Number	:	802-839-6360

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “NORTHLIGHT THERAPY ” Practice Location

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